Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1155/2014/989815 http://repositorio.unifesp.br/handle/11600/37165 |
Resumo: | Objective. To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. the expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. Results. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). Conclusions. This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. in this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care. |
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Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance StudyObjective. To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. the expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. Results. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). Conclusions. This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. in this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care.Univ Campinas UNICAMP, Sch Med Sci, Dept Obstet & Gynaecol, BR-13083881 Campinas, SP, BrazilCtr Res Reprod Hlth Campinas Cemicamp, BR-13083888 Campinas, SP, BrazilUniv Fed Amazonas, Manaus, Amazonas, BrazilSch Med Sci, CISAM, Recife, PE, BrazilUniv Fed Ceara, Fortaleza, Ceara, BrazilUniv Fed Bahia, Salvador, BA, BrazilHosp Geral Cesar Cals, Fortaleza, Ceara, BrazilHosp Geral Fortaleza, Fortaleza, Ceara, BrazilMaternidade Odete Valadares, Belo Horizonte, MG, BrazilHosp Materno Infantil, Goiania, Go, BrazilInst Materno Infantil Pernambuco, Recife, PE, BrazilUniv Fed Pernambuco, Recife, PE, BrazilUniv Fed Campina Grande, Campina Grande, PB, BrazilUniv Fed Maranhao, Sao Luis, MA, BrazilUniv Fed Parana, BR-80060000 Curitiba, Parana, BrazilUniv Fed Paraiba, BR-58059900 Joao Pessoa, Paraiba, BrazilHosp Maternidade Fernando Magalhaes, Rio de Janeiro, RJ, BrazilUniv Fed Rio Grande do Sul, Porto Alegre, RS, BrazilHosp Maternidade Celso Pierro, Campinas, SP, BrazilInst Fernandes Figueira Fiocruz, Rio de Janeiro, RJ, BrazilHosp Israelita Albert Einstein, São Paulo, BrazilUniv State São Paulo, Botucatu, SP, BrazilJundiai Sch Med, Jundiai, SP, BrazilUniv São Paulo, BR-14049 Ribeirao Preto, SP, BrazilSanta Casa Limeira, Limeira, SP, BrazilSanta Casa Sao Carlos, Sao Carlos, SP, BrazilMaternidade Leonor Mendes de Barros, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of ScienceConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CNPq: 402702/2008-5Hindawi Publishing CorporationUniversidade Estadual de Campinas (UNICAMP)Ctr Res Reprod Hlth Campinas CemicampUniv Fed AmazonasSch Med SciUniv Fed CearaUniversidade Federal da Bahia (UFBA)Hosp Geral Cesar CalsHosp Geral FortalezaMaternidade Odete ValadaresHosp Materno InfantilInst Materno Infantil PernambucoUniversidade Federal de Pernambuco (UFPE)Univ Fed Campina GrandeUniv Fed MaranhaoUniv Fed ParanaUniv Fed ParaibaHosp Maternidade Fernando MagalhaesUniv Fed Rio Grande do SulHosp Maternidade Celso PierroInst Fernandes Figueira FiocruzHosp Israelita Albert EinsteinUniversidade de São Paulo (USP)Jundiai Sch MedSanta Casa LimeiraSanta Casa Sao CarlosMaternidade Leonor Mendes de BarrosUniversidade Federal de São Paulo (UNIFESP)Haddad, Samira MaerrawiCecatti, Jose GuilhermeSouza, Joao PauloSousa, Maria HelenaParpinelli, Mary AngelaCosta, Maria LauraPacagnella, Rodolfo C.Brum, Ione R.Moraes Filho, Olimpio B.Feitosa, Francisco E.Menezes, Carlos A.Guanabara, Everardo M.Moreira, Joaquim L.Peret, Frederico A.Schmaltz, Luiza E.Katz, LeilaBarbosa Lima, Antonio C.Amorim, Melania M.Martins, Marilia G.Nascimento, Denis J.Paiva, Claudio S.Rohloff, Roger D.Costa, Sergio M.Luz, Adriana G.Lobato, GustavoCordioli, EduardoPeracoli, Jose C.Maia Filho, Nelson L.Quintana, Silvana M.Lotufo, Fatima A.Andreucci, Carla B.Aquino, Marcia M.Mattar, Rosiane [UNIFESP]2016-01-24T14:34:57Z2016-01-24T14:34:57Z2014-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10application/pdfhttp://dx.doi.org/10.1155/2014/989815Biomed Research International. New York: Hindawi Publishing Corporation, 10 p., 2014.10.1155/2014/989815WOS000340161700001.pdf2314-6133http://repositorio.unifesp.br/handle/11600/37165WOS:000340161700001engBiomed Research Internationalinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-31T17:25:00Zoai:repositorio.unifesp.br/:11600/37165Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-31T17:25Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
spellingShingle |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study Haddad, Samira Maerrawi |
title_short |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_full |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_fullStr |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_full_unstemmed |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
title_sort |
Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study |
author |
Haddad, Samira Maerrawi |
author_facet |
Haddad, Samira Maerrawi Cecatti, Jose Guilherme Souza, Joao Paulo Sousa, Maria Helena Parpinelli, Mary Angela Costa, Maria Laura Pacagnella, Rodolfo C. Brum, Ione R. Moraes Filho, Olimpio B. Feitosa, Francisco E. Menezes, Carlos A. Guanabara, Everardo M. Moreira, Joaquim L. Peret, Frederico A. Schmaltz, Luiza E. Katz, Leila Barbosa Lima, Antonio C. Amorim, Melania M. Martins, Marilia G. Nascimento, Denis J. Paiva, Claudio S. Rohloff, Roger D. Costa, Sergio M. Luz, Adriana G. Lobato, Gustavo Cordioli, Eduardo Peracoli, Jose C. Maia Filho, Nelson L. Quintana, Silvana M. Lotufo, Fatima A. Andreucci, Carla B. Aquino, Marcia M. Mattar, Rosiane [UNIFESP] |
author_role |
author |
author2 |
Cecatti, Jose Guilherme Souza, Joao Paulo Sousa, Maria Helena Parpinelli, Mary Angela Costa, Maria Laura Pacagnella, Rodolfo C. Brum, Ione R. Moraes Filho, Olimpio B. Feitosa, Francisco E. Menezes, Carlos A. Guanabara, Everardo M. Moreira, Joaquim L. Peret, Frederico A. Schmaltz, Luiza E. Katz, Leila Barbosa Lima, Antonio C. Amorim, Melania M. Martins, Marilia G. Nascimento, Denis J. Paiva, Claudio S. Rohloff, Roger D. Costa, Sergio M. Luz, Adriana G. Lobato, Gustavo Cordioli, Eduardo Peracoli, Jose C. Maia Filho, Nelson L. Quintana, Silvana M. Lotufo, Fatima A. Andreucci, Carla B. Aquino, Marcia M. Mattar, Rosiane [UNIFESP] |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual de Campinas (UNICAMP) Ctr Res Reprod Hlth Campinas Cemicamp Univ Fed Amazonas Sch Med Sci Univ Fed Ceara Universidade Federal da Bahia (UFBA) Hosp Geral Cesar Cals Hosp Geral Fortaleza Maternidade Odete Valadares Hosp Materno Infantil Inst Materno Infantil Pernambuco Universidade Federal de Pernambuco (UFPE) Univ Fed Campina Grande Univ Fed Maranhao Univ Fed Parana Univ Fed Paraiba Hosp Maternidade Fernando Magalhaes Univ Fed Rio Grande do Sul Hosp Maternidade Celso Pierro Inst Fernandes Figueira Fiocruz Hosp Israelita Albert Einstein Universidade de São Paulo (USP) Jundiai Sch Med Santa Casa Limeira Santa Casa Sao Carlos Maternidade Leonor Mendes de Barros Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Haddad, Samira Maerrawi Cecatti, Jose Guilherme Souza, Joao Paulo Sousa, Maria Helena Parpinelli, Mary Angela Costa, Maria Laura Pacagnella, Rodolfo C. Brum, Ione R. Moraes Filho, Olimpio B. Feitosa, Francisco E. Menezes, Carlos A. Guanabara, Everardo M. Moreira, Joaquim L. Peret, Frederico A. Schmaltz, Luiza E. Katz, Leila Barbosa Lima, Antonio C. Amorim, Melania M. Martins, Marilia G. Nascimento, Denis J. Paiva, Claudio S. Rohloff, Roger D. Costa, Sergio M. Luz, Adriana G. Lobato, Gustavo Cordioli, Eduardo Peracoli, Jose C. Maia Filho, Nelson L. Quintana, Silvana M. Lotufo, Fatima A. Andreucci, Carla B. Aquino, Marcia M. Mattar, Rosiane [UNIFESP] |
description |
Objective. To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. the expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. Results. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). Conclusions. This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. in this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-01-01 2016-01-24T14:34:57Z 2016-01-24T14:34:57Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1155/2014/989815 Biomed Research International. New York: Hindawi Publishing Corporation, 10 p., 2014. 10.1155/2014/989815 WOS000340161700001.pdf 2314-6133 http://repositorio.unifesp.br/handle/11600/37165 WOS:000340161700001 |
url |
http://dx.doi.org/10.1155/2014/989815 http://repositorio.unifesp.br/handle/11600/37165 |
identifier_str_mv |
Biomed Research International. New York: Hindawi Publishing Corporation, 10 p., 2014. 10.1155/2014/989815 WOS000340161700001.pdf 2314-6133 WOS:000340161700001 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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Biomed Research International |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
10 application/pdf |
dc.publisher.none.fl_str_mv |
Hindawi Publishing Corporation |
publisher.none.fl_str_mv |
Hindawi Publishing Corporation |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268357351833600 |